Annular pancreas (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Assistant Editor-In-Chief: Meagan E. Doherty.

An annular pancreas is a ring of pancreatic tissue that encircles the duodenum (the first part of the small intestine, just below the stomach).

Symptoms of annular pancreas include:

• Feeding intolerance in newborns
• Fullness after eating
• Nausea and vomiting

Annular pancreas is caused by malformation during the development of the pancreas, before birth. This condition may result in a narrowing of the duodenum due to squeezing by the ring of pancreas.

Complete obstruction of the duodenum is often seen in newborns with this condition. However, half of cases are not diagnosed until symptoms occur in adulthood. There are probably many cases that go undetected due to mild symptoms.

People with this condition are more like to have a peptic ulcer.

Call for an appointment with your health care provider if you or your child have any symptoms of annular pancreas.

Signs that may indicate annular pancreas include:

• Down syndrome
• Other congenital (something you are born with) gastrointestinal problems
• Pancreatitis (inflamation of the pancreas)
• Excessive amniotic fluid (the fluid surrounding the baby in pregnancy) during pregnancy (polyhydramnios)

Tests include:

• Abdominal ultrasound
• Abdominal x-ray
• CT scan
• Upper GI and small bowel series

• Pancreatic divisum: failure of the dorsal and ventral pancreatic ducts to fuse resulting in the majority of secretions exiting via the accessory pancreatic
• Pancreatic neoplasms
• Duplication cyst of the duodenum
• Duodenal atresia (failure of canalization of small intestine or part of it)

Surgical bypass of the blocked part of the duodenum is the usual treatment for this disorder.

Directions to hospitals treating annular pancreas

The outcome is usually good with surgery.

• Obstructive jaundice
• Pancreatitis
• Peptic ulcer
• Perforation of the intestine due to obstruction
• Peritonitis

• http://www.nlm.nih.gov/medlineplus/ency/article/001142.htm

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